Coronary heart disease is associated with diet. Nutritional recommendations are frequently provided, but few long term studies on the effect of food choices on heart disease are available. We followed coronary heart disease morbidity and mortality in a cohort of 1752 rural men participating in a prospective observational study. Dietary choices were assessed at baseline with a food questionnaire. 138 men were hospitalized or deceased owing to coronary heart disease during the 12 year follow-up. Daily intake of fruit and vegetables was associated with a lower risk of coronary heart disease when combined with a high dairy fat consumption, but not when combined with a low dairy fat consumption. Consuming wholemeal bread or eating fish at least twice a week showed no association with the outcome.